DP24-004, Core - NYU-CUNY Prevention Research Center

PROJECT SUMMARY/ABSTRACT Racial and ethnic minoritized immigrant communities experience disproportionately higher rates of morbidity and mortality from type 2 diabetes (T2D), cardiovascular disease (CVD), and other chronic diseases than individuals born in the United States. Immigrant populations face significant challenges accessing healthcare and engaging in health-promoting behaviors due to barriers related to social determinants of health (SDOH). The NYU–CUNY Prevention Research Center (PRC) has developed effective approaches to improve access to care and reduce chronic disease disparities in partnership with immigrant and minoritized populations in urban settings. Since 2009, the PRC has played a leading role in generating, translating and adapting evidence-based interventions (EBIs), with a focus on effective models of community health worker (CHW) interventions. The PRC is an innovative and successful public–private partnership between a CEPH-accredited, minority-serving public school of public health (CUNY) and a leading academic medical school with a 15-year history of leadership in the national PRC Network (NYU). In the next cycle, the NYU–CUNY PRC Center will 1) expand and sustain its infrastructure and agenda to accelerate translation of chronic disease research evidence into policy and practice, 2) engage cross-sectoral partners to support translation of research findings into practice and widespread adoption of EBIs, 3) facilitate bi-directional training and technical assistance across partners and PRC networks to support translation of prevention research, and 4) disseminate research findings and translation products. For the PRC's core research project, we propose a type 2 hybrid implementation-effectiveness trial to test a multi- level implementation strategy that addresses key community-, clinic-, and patient-level barriers to uptake and adoption of diabetes self-management education and support (DSMES). We test: 1) a CHW-enabled community- clinic linkage (CCL) model across a network of federally qualified health centers and community-based organizations to improve clinical coordination and address social needs, followed by 2) a series of 24 culturally and linguistically tailored DSMES videos delivered by text message (mhealth) to improve knowledge, skills, and self-efficacy to manage T2D. We will test this multi-level strategy for DSMES uptake among low-income Hispanic and Asian immigrant adults with T2D. We will 1) identify facilitators/barriers to the implementation process and assess patient uptake of specific DSMES delivery strategies (primary implementation outcome); 2) examine the effectiveness of CHW-enabled CCL on reducing HbA1c at 6-months and the effectiveness of additional mhealth on sustaining glycemic control at 12-months (primary effectiveness outcome); and 3) assess and improve the sustainability and scalability of the package using participatory system dynamics modeling. Finally, the NYU- CUNY PRC will support the national PRC network to: 1) engage policymakers around SODH and health outcomes; and 2) adapt, implement, and translate EBIs. Our Center harnesses population health resources and prevention science expertise, and builds upon partnerships to reduce T2D and other chronic disease disparities.